Physiological metric estimation rise and fall limiting

ABSTRACT

Methods and apparatus disclosed herein use a filtering technique to improve the accuracy of the results achieved when processing data provided by a physiological sensor. The disclosed filtering technique corrects many of the accuracy problems associated with physiological sensors, particularly PPG sensors. Broadly, the filtering technique adjusts a current filtered estimate of a physiological metric as a function of a rate limit based on a comparison between an instantaneous estimate of the physiological metric and the current filtered estimate.

This application is a continuation of prior U.S. patent application Ser. No. 14/370,658, filed 3 Jul. 2014, which was the National Stage of International Application No. PCT/US2012/071593, filed 24 Dec. 2012, which claims the benefit of U.S. Provisional Application Ser. No. 61/586,874, filed 16 Jan. 2012, the disclosures of all of which are incorporated by reference herein in their entirety.

The embodiments disclosed herein generally relate to photoplethysmograph (PPG) sensors for monitoring heart rate and other physiological metrics, and more particularly relate to noise reduction techniques for PPG sensors.

BACKGROUND

Personal health monitors provide users with the ability to monitor their overall health and fitness by enabling the user to monitor heart rate or other physiological information during exercise, athletic training, rest, daily life activities, physical therapy, etc. Such devices are becoming increasingly popular as they become smaller and more portable.

A heart rate monitor represents one example of a personal health monitor. A common type of heart rate monitor uses a chest strap monitor that includes surface electrodes to detect muscle action potentials from the heart. Because such surface electrodes provide a relatively noise free signal, the information produced by monitors that use surface electrodes is highly accurate. However, most users find chest strap monitors uncomfortable and inconvenient.

Another type of heart rate monitor uses PPG sensors disposed in an ear bud. The ear provides an ideal location for a monitor because it is a relatively immobile platform that does not obstruct a person's movement or vision. PPG sensors proximate the ear have, e.g., access to the inner ear canal and tympanic membrane (for measuring core body temperature), muscle tissue (for monitoring muscle tension), the pinna and earlobe (for monitoring blood gas levels), the region behind the ear (for measuring skin temperature and galvanic skin response), and the internal carotid artery (for measuring cardiopulmonary functioning). The ear is also at or near the point of the body's exposure to environmental breathable toxins of interest (volatile organic compounds, pollution, etc.), noise pollution experienced by the ear, lighting conditions for the eye, etc. Further, as the ear canal is naturally designed for transmitting acoustical energy, the ear provides a good location for monitoring internal sounds, such as the heartbeat, breathing rate, mouth motion, etc.

PPG sensors measure the relative blood flow using an infrared or other light source that projects light that is ultimately transmitted through or reflected off tissue, and is subsequently detected by a photodetector and quantified. For example, higher blood flow rates result in more light being scattered by the blood, which ultimately increases the intensity of the light that reaches the photodetector. By processing the signal output by the photodetector, a monitor using PPG sensors may measure the blood volume pulse (the phasic change in blood volume with each heartbeat), the heart rate, heart rate variability, and other physiological information. PPG sensors are generally small and may be packaged such that they do not encounter the comfort and/or convenience issues associated with other conventional health monitors. However, PPG sensors are also more sensitive to motion artifact noise than are many other types of sensors, and thus are more prone to accuracy problems.

SUMMARY

The filtering techniques disclosed herein improve the accuracy of a heart rate and/or other physiological metrics provided by a monitor, e.g., one using photoplethysmograph (PPG) sensors. In general, the disclosed filtering technique improves the accuracy by adjusting an estimate of a heart rate as a function of a rate limit associated with the heart rate.

One exemplary method processes data provided by a physiological sensor, e.g., a PPG sensor, to reduce the noise and therefore improve the accuracy of a physiological metric, e.g., a heart rate. The method comprises determining, based on a physiological waveform received from a physiological sensor, an instantaneous estimate of a physiological metric, and comparing the instantaneous estimate to a current filtered estimate of the physiological metric. The method further includes computing a revised filtered estimate of the physiological metric as a function of the current filtered estimate and a rate limit based on the comparison between the instantaneous estimate and the current filtered estimate, and outputting the revised filtered estimate.

One exemplary physiological processor processes data provided by a physiological sensor, e.g., a PPG sensor, to reduce the noise and therefore improve the accuracy of a physiological metric, e.g., a heart rate. The processor comprises a spectral transformer and a filter. The spectral transformer is configured to determine, based on a received waveform, an instantaneous estimate of the physiological metric. The filter is configured to compare the instantaneous estimate to a current filtered estimate of the physiological metric, and output a revised filtered estimate of the physiological metric computed as a function of the current filtered estimate and a rate limit based on the comparison between the instantaneous estimate and the current filtered estimate.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows an exemplary heart rate monitor disposed in an ear bud.

FIG. 2 shows a block diagram of an exemplary physiological monitoring system disposed in a housing.

FIG. 3 shows an exemplary process for determining physiological information from data provided by a physiological sensor.

FIG. 4 shows an exemplary block diagram for the processor of FIG. 2, as configured to implement the process of FIG. 3.

FIG. 5 shows an exemplary block diagram for the filter of FIG. 4.

FIG. 6 shows another exemplary process for determining physiological information from data provided by a physiological sensor.

DETAILED DESCRIPTION

Many of the embodiments disclosed herein are derived from new findings on how vital signs, PPG signals, and acceleration changes within the human body during activity. By understanding the relationship between these changes, a method has been invented to track heart rate and other vital signs in the midst of motion artifact noise and other types of noise that may otherwise lead to erroneous estimations of heart rate and other vital signs.

The filtering technique disclosed herein improves the accuracy of the results achieved when processing data, e.g., heart rate data, provided by a physiological sensor. FIG. 1 shows an exemplary monitoring system 12 disposed in an ear bud 10. The ear bud 10 may comprise a wireless or wired ear bud that communicatively couples to a remote device, e.g., a music player, a smart phone, a personal data assistant, etc. The monitoring system 12 monitors the heart rate and/or other physiological metrics, and outputs such physiological information to the user and/or to other processing functions. While the monitoring system 12 disclosed herein is presented as being part of an ear bud 10, it will be appreciated that monitoring system 12 may be disposed into any device that secures to the body of a user, e.g., a device that secures to an ear, finger, toe, limb (arm, leg, ankle, etc.), wrist, nose, etc. In some embodiments, the device may comprise a patch, e.g., a bandage, designed to attach the system 12 to any desired location on the user's body.

FIG. 2 shows a block diagram of an exemplary monitoring system 12 according to one exemplary embodiment. System 12 comprises a processor 100 coupled to one or more physiological sensors 20, a memory 30, and an output interface 40. As discussed further herein, system 12 may also include an optional inertial sensor 50 configured to sense energy, e.g., motion, external to the system 12. Physiological sensor(s) 20 produce a physiological waveform responsive to the physiological state of the user. Processor 100 processes the physiological waveform using the filtering technique disclosed herein, along with information stored in memory 30, to determine a heart rate and/or one or more physiological metrics with improved accuracy. Output interface 40 outputs the determined physiological metric(s). It will be appreciated that output interface may comprise a transceiver for transmitting the data output by the processor 100 to a remote device. Alternatively or additionally, the output interface may provide the output data to a user interface, e.g., a display, a database, another processor, and/or a processing function.

In exemplary embodiments, the physiological sensors 20 comprise photoplethysmograph (PPG) sensors that generate an electrical physiological waveform responsive to detected light intensity. PPG sensors comprise light intensity sensors that generally rely on optical coupling of light into the blood vessels. As used herein, the term “optical coupling” refers to the interaction or communication between excitation light entering a region and the region itself. For example, one form of optical coupling may be the interaction between excitation light generated from within a light-guiding ear bud 10 and the blood vessels of the ear. Light guiding ear buds are described in co-pending U.S. Patent Application Publication No. 2010/0217102, which is incorporated herein by reference. In one embodiment, the interaction between the excitation light and the blood vessels may involve excitation light entering the ear region and scattering from a blood vessel in the ear such that the intensity of the scattered light is proportional to blood flow within the blood vessel. Another form of optical coupling may result from the interaction between the excitation light generated by an optical emitter within the ear bud and the light-guiding region of the ear bud.

Processor 100 determines one or more physiological metrics from the physiological waveform and filters the determined metric(s) to produce a revised physiological metric having an improved accuracy. The determined physiological metric may also refer to a physiological assessment computed from one or more physiological metrics. For simplicity, the following describes the processor 100 in terms of determining a heart rate. However, the processor 100 may alternatively or additionally determine other physiological metrics, e.g., a respiration rate, a heart rate variability (HRV), a pulse pressure, a systolic blood pressure, a diastolic blood pressure, a step rate, an oxygen uptake (VO₂), an R-R interval (which represents the interval between successive R-peaks in an ECG waveform), a maximal oxygen uptake (VO₂ max), calories burned, trauma, cardiac output and/or blood analyte levels including percentage of hemoglobin binding sites occupied by oxygen (SPO₂), percentage of methomoglobins, a percentage of carbonyl hemoglobin, and/or a glucose level. Alternatively or additionally, processor 100 may determine and filter one or more physiological assessments, e.g., a ventilatory threshold, lactate threshold, cardiopulmonary status, neurological status, aerobic capacity (VO₂ max), and/or overall health or fitness. Though heart rate is used as an example of a specific physiological metric that may be accurately extracted using the embodiments disclosed herein, it should be understood that other physiological metrics may also be derived using these embodiments. Periodically changing vital signs, such as, but not limited to, heart rate, respiration rate, R-R interval, circadian changes, blood-gas level changes, and the like may be particularly suited for signal extraction under the described embodiments.

FIG. 3 shows an exemplary method 200 that may be implemented by processor 100 to compute a revised heart rate. After processor 100 receives the physiological waveform from the sensor(s) 20 (block 210), the processor 100 determines an instantaneous estimate P_(inst) of the heart rate. After comparing P_(inst) to a current filtered estimate P_(filt), which may be retrieved from memory 30, processor 100 computes a revised filtered estimate {circumflex over (P)}_(filt) of the heart rate as a function of P_(filt) and a rate limit Δ_(r) based on the comparison (block 230), where Δ_(r) may also be retrieved from memory 30. Processor 100 subsequently outputs the revised filtered estimate {circumflex over (P)}_(filt) to output 40 (block 240). It will be appreciated that processor 100 may also store the revised filtered estimate {circumflex over (P)}_(filt) in memory 30, e.g., so that it may be used in subsequent calculations and/or as a current filtered estimate P_(filt). As used herein, the rate limit represents a limit to the rate of change for the heart rate. For example, the rate limit may represent the rate of change in beats per minute (BPM) that the heart rate may experience in a 1 second frame period. Such a rate limit may be determined based on empirical evidence, and is generally predetermined. It will be appreciated that the rate limit may be expressed as the rate of change experienced for any length frame period, where for example, the rate limit in BPM/s is multiplied by the length of the frame period (in seconds).

FIG. 4 shows a block diagram of an exemplary processor 100 configured to process the physiological waveform provided by the sensor(s) 20. Processor 100 comprises a spectral transformer 110 and a filter 120. Spectral transformer 110 spectrally transforms the physiological waveform received from the sensor(s) 20 to determine one or more heuristic properties of the physiological waveform and provides the heuristic properties to the filter 120. For example, the spectral transformer 110 may evaluate the spectrally transformed waveform to identify the spectral peak having the largest amplitude. The spectral transformer 110 then defines the frequency of the peak with the largest amplitude as the instantaneous estimate P_(inst) of the heart rate. Filter 120 filters the instantaneous estimate P_(inst) of the heart rate to compute the revised filter estimate {circumflex over (P)}_(filt) as a function of P_(filt) and Δ_(r) based on a comparison between P_(filt) and P_(inst).

To illustrate, consider the following example. If the instantaneous heart rate is greater than or equal to the current filtered heart rate, filter 120 may compute the revised filter estimate as a function of a rising/increasing heart rate limit Δ_(r+) and the current filtered heart rate, e.g., according to: {circumflex over (P)} _(filt) =P _(filt)+min(Δ_(r+) ,P _(inst) −P _(filt)),  (1)

where, the rising heart rate limit Δ_(r+) is, e.g., 6 BPM in a 1 second frame period. If, however, the instantaneous heart rate is less than the current filtered heart rate, filter 120 may compute the revised filter estimate as a function of a falling heart rate limit Δ_(r−) and the current filtered heart rate, e.g., according to: {circumflex over (P)} _(filt) =P _(filt)+max(Δ_(r−) ,P _(inst) −P _(filt)),  (2)

where, the falling heart rate limit Δ_(r−) is, e.g., −4.

t FIG. 5 shows a block diagram of an exemplary filter 120. In one embodiment, filter 120 comprises an adjustment processor 130 and a combiner 122. Combiner 122 combines an adjustment parameter Δ_(a) output by adjustment processor 130 with P_(filt) to compute the revised filtered estimate {circumflex over (P)}_(filt) of the heart rate. Adjustment processor 130 comprises a function processor 132 configured to compute Δ_(a) as a function of the rate limit Δ_(r) and the current filtered estimate P_(filt) responsive to the comparison between the instantaneous estimate P_(inst) and the current filtered estimate P_(filt). Using the previous example, when P_(inst)≥P_(filt), function processor 132 may compute the adjustment parameter Δ_(a) according to: Δ_(a)=min(Δ_(r+) ,P _(inst) −P _(filt))  (3)

If, however P_(inst)<P_(filt), function processor 132 may compute the adjustment parameter Δ_(a) according to: Δ_(a)=max(Δ_(r−) ,P _(inst) −P _(filt)).  (4)

In some embodiments, adjustment processor 130 selects either the rising or falling rate limit used by function processor 132 based on the comparison between the instantaneous estimate and the current filtered estimate. Alternatively, filter 120 may include a rate processor 124 that selects an initial rate limit Δ_(init), which may comprise the rising or falling rate limit, based on the comparison between the instantaneous estimate and the current filtered estimate. In still another embodiment, the function processor 132 may comprise different processing paths associated with different comparison results, where adjustment processor 130 selects one of the processing paths based on the comparison between the instantaneous estimate and the current filtered estimate, where each processing path is associated with a different one of Equations (1)/(3) and (2)/(4), and where each processing path includes the corresponding rate limit.

It will also be appreciated that the different values disclosed herein for the rising and falling rate limits are exemplary and non-limiting. In some embodiments, the magnitude of the rising rate limit may equal the magnitude of the falling rate limit. Alternatively or additionally, while the rising and falling rate limits may respectively comprise positive and negative values, such is not required. For example, when the falling rate limit is set to a positive value, Equation (4) may be modified according to: Δ_(a)=−min(Δ_(r−) ,P _(filt) −P _(inst))  (5)

Similar modifications to Equation (3) may be made when the rising rate limit is set to a negative value.

Adjustment processor 130 may further include a modifier processor 134 configured to compute one or more modifiers based on one or more of the heuristic properties, and further configured to determine the rate limit as a function of the modifier(s) and an initial rate limit Δ_(init), e.g., as provided by rate processor 124. Accordingly, modifier processor 134 includes a calculator 136 and a modifier applicator 138. Calculator 136 computes one or more modifiers based on the one or more heuristic properties of the physiological waveform provided by the spectral transform. In some embodiments, the modifier(s) represent a reliability of the initial rate limit Δ_(init). Modifier applicator 138 subsequently applies the computed modifier(s) to the initial rate limit Δ_(init), e.g., by summing and/or multiplying the initial rate limit Δ_(init) by the computed modifier(s), to determine the rate limit Δ_(r) used by function processor 132. It will be appreciated that the modifier(s) may be applied to any initial rate limit Δ_(init), including the rising rate limit, the falling rate limit, or both, and that when function processor 132 uses different processing paths based on the comparison between P_(inst) and P_(filt), the modifiers are applied to the rate limits of one or more of the processing paths as needed/desired.

In one exemplary embodiment, calculator 136 computes a spectral modifier α₁ based on heuristic properties of the physiological waveform comprising spectral characteristics of the instantaneous estimate of the heart rate. The spectral modifier quantifies the reliability (or confidence) that the spectral transformer 110 associated the instantaneous estimate with the correct spectral peak. Broadly, when there is a large difference in magnitude between the spectral peak having the largest magnitude and the spectral peak having the next largest magnitude, there is a high degree of confidence that the largest spectral peak corresponds to the instantaneous heart rate of interest. More particularly, the spectral transformer 110 may provide the spectral characteristics for some number of the spectral peaks of the spectrally transformed waveform, e.g., the magnitude(s) of two or more spectral peaks. For example, the spectral transformer may provide the magnitude of the largest spectral peak SPM₁ and the magnitude of the second largest spectral peak SPM₂ to the calculator 136. Based on the provided spectral magnitudes, calculator 136 calculates the spectral modifier. For example, calculator 136 may compute the spectral modifier according to:

$\begin{matrix} {\alpha_{1} = {1 - {\frac{{SPM}_{2}}{{SPM}_{1}}.}}} & (6) \end{matrix}$

Subsequently, modifier applicator 138 applies the spectral modifier according to: Δ_(r)=α₁Δ_(init)  (7)

It will be appreciated that applicator 138 may apply the spectral modifier to the initial rate limit Δ_(init) using linear means, e.g., multiplication, addition, subtraction, and/or division, or using non-linear means, e.g., norm, RMS, min, or max functions. It should be noted that if the magnitude of the largest peak (SPM₁) and the magnitude of the 2^(nd) largest peak (SPM₂) are identical, then α₁=0, such that the rate limit Δ_(r) is zero. With the rate limit at zero, the reported physiological metric {circumflex over (P)}_(filt) (which in this specific case is the reported heart rate) may not change.

In another exemplary embodiment, calculator 136 computes a boundary modifier α² as a function of boundary values bounding the heart rate based on the comparison between the instantaneous estimate and the current filtered estimate. The boundary modifier also quantifies the reliability (or confidence) that the spectral transformer 110 associated the instantaneous estimate of the heart rate with the correct spectral peak based on the difference between the current filtered estimate and the instantaneous estimate. When there is a large difference between the instantaneous and current filtered estimates, there is a low degree of confidence that the instantaneous estimate is correct. More particularly, when the instantaneous estimate is greater than or equal to the current filtered estimate, the calculator 136 may compute the boundary modifier according to:

$\begin{matrix} {{\alpha_{2} = \frac{P_{\max} - P_{inst}}{P_{\max} - P_{filt}}},} & (8) \end{matrix}$

where P_(max) represents an upper boundary for the heart rate. For example, P^(max) may be set equal to 225 BPM. When the instantaneous estimate is less than the current filtered estimate, the calculator 136 may compute the boundary modifier according to:

$\begin{matrix} {{\alpha_{2} = \frac{P_{{in}{st}} - P_{\min}}{P_{filt} - P_{\min}}},} & (9) \end{matrix}$

where P_(min) represents a lower boundary for the heart rate. For example, P_(min) may be set equal to 40 BPM. Subsequently, modifier applicator 138 applies the boundary modifier according to: Δ_(r)=α₂Δ_(init)  (10)

It will be appreciated that applicator 138 may apply the boundary modifier to the initial rate limit Δ_(init) using linear means, e.g., multiplication, addition, subtraction, and/or division, or using non-linear means, e.g., norm, RMS, min, or max functions. It will also be appreciated that the upper and lower heart rate boundaries are based on empirical evidence, which indicates that most people, whether at rest or exercising, have a heart rate between 40 and 225 BPM.

In still another embodiment, calculator 136 may compute the spectral and boundary modifiers, as previously described. Subsequently, applicator 138 applies the spectral and boundary modifiers according to: Δ_(r)=α₁α₂Δ_(init)  (11)

It will be appreciated that applicator 138 may apply the spectral and boundary modifiers to the initial rate limit Δ_(init) using linear means, e.g., multiplication, addition, subtraction, and/or division, or using non-linear means, e.g., norm, RMS, min, or max functions. It will further be appreciated that other modifier(s) determined based on one or more heuristic properties of the physiological waveform may be additionally or alternatively applied to the initial rate limit Δ_(init) to determine Δ_(r).

Embodiments disclosed heretofore filter an estimate of the heart rate derived from a spectral transformation of the physiological waveform output by the sensor(s) 20. While such filtering improves the accuracy of the output heart rate, it will be appreciated that the accuracy may further be improved through the use of noise reduction techniques applied to the physiological waveform and/or to the instantaneous estimate before applying the filtering technique. For example, processor 100 may include an optional noise filter 140 (FIG. 4) configured to filter the physiological waveform output by the sensor(s) 20 to generate a noise-reduced waveform, e.g., a waveform free of breathing noise. In this example, spectral transformer 110 determines the instantaneous estimate and/or other spectral information used during the filtering process based on the noise-reduced waveform. In so doing, the processor 100 reduces the noise present in the instantaneous estimate and/or the revised filtered estimate. Alternatively or additionally, system 12 may include an optional inertial sensor 50 (FIG. 2), e.g., a motion sensor, configured to receive an inertial waveform representative of external energy, e.g., external motion. The motion sensor 50 may comprise one or more of any number of types of sensors, including but not limited to an accelerometer, an optical emitter/detector pair, an optical detector, a CCD camera, a piezoelectric sensor, a thermal sensor, or any type of sensor capable of capturing motion information. Exemplary optical emitters comprise one or more light emitting diodes, laser diodes, organic light-emitting diodes, miniature light emitters, electromagnetic emitters, etc. It will be appreciated that the sensors disclosed herein are not limited to optical wavelengths of the electromagnetic spectrum. In some embodiments, emitters and/or detectors configured for shorter or longer wavelengths may be used to accommodate shorter or longer wavelengths in the electromagnetic spectrum. The optical detector may comprise a photodetector, an electromagnetic detector, a photodiode, etc. In the filtering embodiment, spectral transformer 110 determines the instantaneous estimate and/or other spectral information used during the filtering process based on the inertial spectrum determined for the inertial waveform and the physiological spectrum determined for the physiological waveform. In so doing, the processor 100 reduces noise attributable to external energy/motion, e.g., energy due to a poor fit of the ear bud, shadows, etc., to reduce the noise present in the instantaneous estimate and/or the revised filtered estimate. For example, the spectral transformer may subtract the physiological and inertial spectrums to determine a reduced noise spectrum, and then may identify the frequency associated with the spectral peak having the largest magnitude as the instantaneous estimate of the heart rate. In still another embodiment, noise filter 140 may receive the inertial waveform and filter the physiological waveform based on the inertial waveform to generate the noise reduced waveform, where the spectral transformer 110 determines the instantaneous estimate and/or other spectral information based on the noise-reduced waveform.

FIG. 6 shows one exemplary method 250 for the embodiment where the spectral and boundary modifiers are used to compute the rate limit used to determine {circumflex over (P)}_(filt), and where the inertial waveform provided by an inertial sensor 50 is used to reduce noise as described herein. In this exemplary embodiment, P_(filt) optionally comprises a current filtered heart rate initially set equal to 83 BPM (block 252). Spectral transformer 110 spectrally transforms the physiological and inertial waveforms respectively received from the physiological and inertial sensors (blocks 254, 256). The spectral transformer 110 subsequently identifies the frequency of the dominant peak of the spectrally transformed inertial waveform (SRF₁), computes the difference between the physiological and inertial spectrums (S), identifies the magnitudes of the dominant and second dominant peaks of S (SPM₁ and SPM₂, respectively), sets P_(inst) equal to the frequency of the dominant peak (SPF₁) (block 258), and provides at least P_(inst) to the filter 120. After comparing to P_(filt) to P_(inst) (block 260), filter 120 performs a filtering operation based on the comparison. For example, filter 120 performs the operations of block 262 when P_(inst)≥P_(filt), and performs the operations of block 264 when P_(inst)<P_(filt). Subsequently, the processor outputs P_(filt) (block 266).

The embodiments disclosed herein improve the accuracy of heart rates determined based on physiological waveforms provided by physiological sensors, particularly noise sensitive sensors, e.g., PPG sensors. In particular, the embodiments disclosed herein reduce the impact of noise sources not previously addressed by past systems, e.g., motion noise due to a user's jaw movement and/or breathing, shadow/sunlight flicker due to a user's movement into and out of shaded areas, light noise due to ambient light being detected by the photodetector, etc.

While the present invention is described in terms of PPG sensors, it will be appreciated that sensors 20 may comprise any sensor able to generate a physiological waveform, e.g., an electroencephalogram (EEG) waveform, and electrocardiogram (ECG) waveform, a radio frequency (RF) waveform, an electro-optical physiological waveform, a thermoelectric waveform, and electro-photoacoustic waveform including a photoacoustic waveform, an electro-mechanical physiological waveform, and/or an electro-nuclear physiological waveform.

The present invention may, of course, be carried out in other ways than those specifically set forth herein without departing from essential characteristics of the invention. The present embodiments are to be considered in all respects as illustrative and not restrictive, and all changes coming within the meaning and equivalency range of the appended claims are intended to be embraced therein. 

What is claimed is:
 1. A physiological processor disposed in a device secured to a body of a user, the physiological processor configured to process a time domain photoplethysmography waveform provided by a photoplethysmography sensor disposed in the device and in contact with skin of the user, the processor comprising: a spectral transformer configured to: convert the photoplethysmography waveform from the time domain to a frequency domain to generate a spectrum; identify a first spectral peak having a largest magnitude in the spectrum and a second spectral peak having a next largest magnitude in the spectrum; and determine, responsive to the spectrum, an instantaneous estimate of a heart rate; and a filter operatively connected to the spectral transformer and configured to: compare the instantaneous estimate to a current filtered estimate of the heart rate; determine of a rising rate limit or a falling rate limit depending respectively on whether the instantaneous estimate is larger or smaller than the current filtered estimate, wherein the rising rate limit or falling rate limit is determined relative to the current filtered estimate as a function of the first spectral peak and the second spectral peak; compute a revised filtered estimate of the heart rate as: a function of the rising rate limit when the instantaneous estimate is greater than or equal to the current filtered estimate; a function of the falling rate limit when the instantaneous estimate is less than the current filtered estimate; and output, to an output interface, the revised filtered estimate of the heart rate.
 2. The physiological processor of claim 1 wherein the physiological processor is further configured to process information provided by the photoplethysmography sensor to determine at least one additional dynamically changing vital sign different from the heart rate.
 3. The physiological processor of claim 1 wherein the current filtered estimate subtracted from the instantaneous estimate comprises a difference, and wherein the filter computes the revised filtered estimate of the heart rate by: when the instantaneous estimate is greater than or equal to the current filtered estimate, computing the revised filtered estimate of the heart rate as a sum of the current filtered estimate and a minimum of the rising rate limit and the difference; and when the instantaneous estimate is less than the current filtered estimate, computing the revised filtered estimate of the heart rate as a sum of the current filtered estimate and a maximum of a falling rate limit and the difference.
 4. The physiological processor of claim 1 wherein when the instantaneous estimate is greater than or equal to the current filtered estimate, the filter computes the revised filtered estimate of the heart rate by: adding the current filtered estimate to the falling rate limit to compute a first value; adding the current filtered estimate to the rising rate limit to compute a second value; determining a minimum of the second value and the instantaneous estimate to compute a third value; and computing the revised filtered estimate of the heart rate as a maximum of the first value and the third value.
 5. The physiological processor of claim 1 wherein when the instantaneous estimate is less than the current filtered estimate, the filter computes the revised filtered estimate of the heart rate by: adding the current filtered estimate to the rising rate limit to compute a first value; adding the current filtered estimate to the falling rate limit to compute a second value; determining a maximum of the second value and the instantaneous estimate to compute a third value; and computing the revised filtered estimate of the heart rate as a minimum of the first value and the third value.
 6. The physiological processor of claim 1 wherein the rising rate limit and the falling rate limit have different magnitudes.
 7. A method of processing data provided by a physiological sensor disposed in a device secured to a body of a user such that the physiological sensor is in contact with skin of the user, the method comprising: receiving a time domain physiological waveform from the physiological sensor; converting, using a spectral transformer disposed in the device and operatively connected to the physiological sensor, the received physiological waveform from the time domain to a frequency domain to generate a physiological spectrum; identifying a first spectral peak having a largest magnitude in the spectrum and a second spectral peak having a next largest magnitude in the spectrum; determining, using the physiological spectrum, an instantaneous estimate of a physiological metric; comparing, using a filter disposed in the device and operatively connected to the spectral transformer, the instantaneous estimate to a current filtered estimate of the physiological metric; determining, using the filter, a rising rate limit or a falling rate limit depending respectively on whether the instantaneous estimate is larger or smaller than the current filtered estimate, wherein the rising rate limit or falling rate limit is determined relative to the current filtered estimate as a function of the first spectral peak and the second spectral peak; computing, using the filter, a revised filtered estimate of the physiological metric as: a function of the rising rate limit when the instantaneous estimate is greater than or equal to the current filtered estimate; a function of the falling rate limit when the instantaneous estimate is less than the current filtered estimate; and outputting the revised filtered estimate to an output interface.
 8. The method of claim 7 wherein outputting the revised filter estimate comprises outputting the revised filter estimate to at least one of a user interface, a transceiver, a database, a processor, and a processing function.
 9. The method of claim 7 wherein the physiological metric comprises a heart rate.
 10. The method of claim 7 wherein receiving the physiological waveform comprises receiving the physiological waveform from a photoplethysmography (PPG) sensor.
 11. The method of claim 7 wherein the current filtered estimate subtracted from the instantaneous estimate comprises a difference, and wherein computing the revised filtered estimate of the physiological metric comprises: when the instantaneous estimate is greater than or equal to the current filtered estimate, computing the revised filtered estimate of the physiological metric as a sum of the current filtered estimate and a minimum of the rising rate limit and the difference; and when the instantaneous estimate is less than the current filtered estimate, computing the revised filtered estimate of the physiological metric as a sum of the current filtered estimate and a maximum of the falling rate limit and the difference.
 12. The method of claim 7 wherein when the instantaneous estimate is greater than or equal to the current filtered estimate, the computing the revised filtered estimate of the physiological metric comprises: adding the current filtered estimate to the falling rate limit to compute a first value; adding the current filtered estimate to the rising rate limit to compute a second value; determining a minimum of the second value and the instantaneous estimate to compute a third value; and computing the revised filtered estimate of the physiological metric as a maximum of the first value and the third value.
 13. The method of claim 7 wherein when the instantaneous estimate is less than the current filtered estimate, the computing the revised filtered estimate of the physiological metric comprises: adding the current filtered estimate to the rising rate limit to compute a first value; adding the current filtered estimate to the falling rate limit to compute a second value; determining a maximum of the second value and the instantaneous estimate to compute a third value; and computing the revised filtered estimate of the physiological metric as a minimum of the first value and the third value.
 14. The method of claim 7 wherein the rising rate limit and the falling rate limit have different magnitudes.
 15. The method of claim 7 wherein the function of the first spectral peak and the second spectral peak comprises summing a magnitude of the first spectral peak with a magnitude of the second spectral peak.
 16. The method of claim 7 wherein the function of the first spectral peak and the second spectral peak comprises multiplying a magnitude of the first spectral peak with a magnitude of the second spectral peak.
 17. The method of claim 7 wherein determining the rising rate limit or the falling rate limit relative to the current filtered estimate as the function of the first spectral peak and the second spectral peak comprises determining the rising rate limit or the falling rate limit relative to the current filtered estimate as a function of the first spectral peak, the second spectral peak, and a predetermined initial rate limit.
 18. The method of claim 17 further comprising computing a first modifier as a function of a boundary value associated with the physiological metric and one or more properties of the physiological waveform, and wherein determining the rising rate limit or the falling rate limit relative to the current filtered estimate as the function of the first spectral peak, the second spectral peak, and the predetermined initial rate limit comprises applying the first modifier to the predetermined initial rate limit.
 19. The method of claim 17 further comprising computing a first modifier as a function of the first spectral peak and the second spectral peak, wherein determining the rising rate limit or the falling rate limit relative to the current filtered estimate as the function of the first spectral peak, the second spectral peak and the predetermined initial rate limit comprises applying the first modifier to the predetermined initial rate limit.
 20. The method of claim 19 further comprising computing a second modifier as a function of a boundary value associated with the physiological metric and one or more properties of the physiological waveform, wherein determining the rising rate limit or the falling rate limit relative to the current filtered estimate as the function of the first spectral peak, the second spectral peak, and the predetermined initial rate limit comprises applying the first and second modifiers to the predetermined initial rate limit.
 21. The method of claim 19 wherein computing the first modifier comprises computing the first modifier as a function of a ratio between the second spectral peak and the first spectral peak.
 22. The method of claim 7 wherein the rising rate limit comprises a first rate limit for an increasing physiological metric and the falling rate limit comprises a second rate limit for a decreasing physiological metric, where a magnitude of the first rate limit relative to the current filtered estimate is different from a magnitude of the second rate limit relative to the current filtered estimate, the method further comprising selecting the first or second rate limit responsive to the comparison between the instantaneous estimate and the current filtered estimate.
 23. A physiological processor disposed in a device secured to a body of a user, the physiological processor configured to process a time domain physiological waveform provided by a physiological sensor disposed in the device and in contact with skin of the user, the processor comprising: a spectral transformer configured to: convert the physiological waveform from the time domain to a frequency domain to generate a physiological spectrum; identify a first spectral peak having a largest magnitude in the spectrum and a second spectral peak having a next largest magnitude in the spectrum; and determine, using the physiological spectrum, an instantaneous estimate of a physiological metric; and a filter operatively connected to the spectral transformer and configured to: compare the instantaneous estimate to a current filtered estimate of the physiological metric; determine a rising rate limit or a falling rate limit depending respectively on whether the instantaneous estimate is larger or smaller than the current filtered estimate, wherein the rising rate limit or falling rate limit is determined relative to the current filtered estimate as a function of the first spectral peak and the second spectral peak; compute a revised filtered estimate of the physiological metric as: a function of the rising rate limit when the instantaneous estimate is greater than or equal to the current filtered estimate; a function of the falling rate limit when the instantaneous estimate is less than the current filtered estimate; and output, to an output interface, the revised filtered estimate of the physiological metric.
 24. The physiological processor of claim 23 further comprising an output element configured to receive the revised filter estimate from the filter, said output element comprising at least one of a user interface, transceiver, a database, a processor, and a processing function.
 25. The physiological processor of claim 23 wherein the physiological metric comprises a heart rate.
 26. The physiological processor of claim 23 wherein the physiological sensor comprises a photoplethysmography (PPG) sensor.
 27. The physiological processor of claim 23 wherein the current filtered estimate subtracted from the instantaneous estimate comprises a difference, and wherein the filter computes the revised filtered estimate of the physiological metric by: when the instantaneous estimate is greater than or equal to the current filtered estimate, computing the revised filtered estimate of the physiological metric as a sum of the current filtered estimate and a minimum of the rising rate limit and the difference; and when the instantaneous estimate is less than the current filtered estimate, computing the revised filtered estimate of the physiological metric as a sum of the current filtered estimate and a maximum of the falling rate limit and the difference.
 28. The physiological processor of claim 23 wherein when the instantaneous estimate is greater than or equal to the current filtered estimate, the filter computes the revised filtered estimate of the physiological metric by: adding the current filtered estimate to the falling rate limit to compute a first value; adding the current filtered estimate to the rising rate limit to compute a second value; determining a minimum of the second value and the instantaneous estimate to compute a third value; and computing the revised filtered estimate of the physiological metric as a maximum of the first value and the third value.
 29. The physiological processor of claim 23 wherein when the instantaneous estimate is less than the current filtered estimate, the filter computes the revised filtered estimate of the physiological metric by: adding the current filtered estimate to the rising rate limit to compute a first value; adding the current filtered estimate to the falling rate limit to compute a second value; determining a maximum of the second value and the instantaneous estimate to compute a third value; and computing the revised filtered estimate of the physiological metric as a minimum of the first value and the third value.
 30. The physiological processor of claim 23 wherein the rising rate limit and the falling rate limit have different magnitudes.
 31. The physiological processor of claim 23 wherein the function of the first spectral peak and the second spectral peak comprises a sum of a magnitude of the first spectral peak with a magnitude of the second spectral peak.
 32. The physiological processor of claim 23 wherein the function of the first spectral peak and the second spectral peak comprises multiplying a magnitude of the first spectral peak with a magnitude of the second spectral peak.
 33. The physiological processor of claim 24 wherein the filter is configured to determine the rising rate limit or the falling rate limit relative to the current filtered estimate by determining the rising rate limit or the falling rate limit relative to the current filtered estimate as a function of the first spectral peak, the second spectral peak, and a predetermined initial rate limit.
 34. The physiological processor of claim 33 wherein the filter comprises: a calculator configured to compute a first modifier as a function of a boundary value associated with the physiological metric and one or more properties of the physiological waveform; and a modifier applicator configured to apply the first modifier to the predetermined initial rate limit to determine the rising rate limit or the falling rate limit relative to the current filtered estimate.
 35. The physiological processor of claim 33 wherein the filter comprises: a calculator configured to compute a first modifier as a function of the first spectral peak and the second spectral peak; and a modifier applicator configured to apply the first modifier to the predetermined initial rate limit to determine the rising rate limit or the falling rate limit relative to the current filtered estimate.
 36. The physiological processor of claim 35 wherein the calculator is further configured to compute a second modifier as a function of a boundary value associated with the physiological metric and one or more properties of the physiological waveform, and wherein the modifier applicator is configured to apply the first and second modifiers to the predetermined initial rate limit to determine the rising rate limit or the falling rate limit relative to the current filtered estimate.
 37. The physiological processor of claim 35 wherein the calculator is configured to compute the first modifier as a function of a ratio between a second spectral peak of the one or more spectral peaks and the first spectral peak, said second spectral peak having a smaller amplitude than the first spectral peak and a larger amplitude than the remaining spectral peaks.
 38. The physiological processor of claim 23 wherein the rising rate limit comprises a first rate limit for an increasing physiological metric and the falling rate limit comprises a second rate limit for a decreasing physiological metric, where a magnitude of the first rate limit relative to the current filtered estimate is different from a magnitude of the second rate limit relative to the current filtered estimate, and wherein the filter comprises a rate processor configured to select the first rate limit or the second rate limit responsive to the comparison between the instantaneous estimate and the current filtered estimate. 